Having pain on the left side in the lower pelvic area can be concerning. There are many possible causes, from minor issues like dietary changes to more serious conditions like ovarian cysts. Here is an overview of the most common reasons for left-sided pelvic pain and ways to find relief.
Common Causes of Left Lower Pelvic Pain
Some of the most frequent explanations for pain on the left side of the pelvis include:
- Menstrual cramps – Many women experience pelvic pain during their periods. Prostaglandins released during menstruation trigger muscle contractions in the uterus which can radiate to the lower abdomen and pelvis.
- Ovarian cysts – Fluid-filled sacs that form on the ovaries often cause dull, aching pain on the side of the ovary with the cyst. Cysts are usually harmless but can sometimes twist or rupture leading to severe pain.
- Urinary tract infection (UTI) – UTIs that involve the ureters and bladder can cause pelvic pain and discomfort. This typically affects both sides of the pelvis though may be more noticeable on one side.
- Irritable bowel syndrome (IBS) – IBS often causes lower left abdominal pain that can extend into the pelvis. This occurs from bowel spasms and intestinal cramping.
- Endometriosis – When uterine tissue grows outside of the uterus, it can implant on pelvic organs like the ovaries. This frequently leads to left-sided pelvic pain, especially around menstrual periods.
- Diverticulitis – Inflammation or infection of small pouches called diverticula that form in the colon can lead to pain in the lower left side of the abdomen spreading to the pelvis.
- Kidney stones – Pelvic pain can radiate from the left kidney if a large stone is present and obstructing urine flow down the left ureter.
- Pelvic inflammatory disease – Pelvic infections like PID that involve the uterus, ovaries or fallopian tubes commonly cause pain on the left side of the pelvis along with fever and abnormal vaginal discharge.
When to See a Doctor
In many cases, minor muscle pulls or menstrual cramps cause some temporary left pelvic discomfort. However, it is important to see a doctor if you experience:
- Severe or persistent pain on one side of your pelvis
- Pain accompanied by fever, chills, nausea or vomiting
- Abnormal vaginal bleeding or discharge
- Pain during sex or urination
- Sudden, severe abdominal pain that spreads to the pelvis
These symptoms can indicate an underlying condition requiring medical treatment. Seeking prompt medical care is crucial for an accurate diagnosis and to rule out serious issues like ectopic pregnancy, ovarian torsion or pelvic infection.
Diagnosis
To determine the cause of left-sided pelvic pain, the doctor will begin with a full medical history and physical exam. They will ask about your symptoms, any related factors like menstrual changes and sexual activity, and past health conditions. The physical exam will involve an external and internal pelvic assessment.
The doctor may then recommend the following tests:
- Pelvic ultrasound – Sound waves produce images of pelvic structures like the uterus, ovaries and fallopian tubes to identify abnormalities.
- CT scan – Cross-sectional X-rays provide detailed views of organs and tissues in the pelvis.
- Laparoscopy – A small camera inserted through an incision allows the doctor to directly visualize the pelvis and abdomen.
- Blood and urine tests – Lab tests can detect infections, pregnancy issues and other problems.
- STD testing – Swabs and cultures check for sexually transmitted causes of pelvic inflammation.
By combining the exam findings, medical history and results of diagnostic tests, the doctor can make an accurate diagnosis and determine appropriate treatment options.
Common Conditions Causing Left Pelvic Pain
Here is an overview of some frequent diagnoses that lead to pain on the left side of the pelvis:
Ovarian Cysts
Ovarian cysts are fluid-filled sacs that develop on an ovary. Many women develop small, harmless cysts that resolve on their own. However, some cysts grow large, rupture, or twist the ovary causing severe left-sided pain.
Endometriosis
Cells from the uterine lining can implant onto pelvic structures like the ovaries and spread into pelvic tissue, scarring these areas. This leads to chronic pelvic pain worsening around periods.
Pelvic Inflammatory Disease
Bacterial infections in the reproductive system often cause inflammation and pain in the pelvis. PID typically causes left-sided pelvic pain along with abnormal vaginal discharge, bleeding or fever.
Diverticulitis
Small pouches called diverticula can form in weak spots of the colon and become inflamed or infected. This frequently leads to intense left lower abdominal and pelvic pain.
Kidney Stones
Kidney stones cause excruciating flank pain that can radiate down through the pelvis as the stone passes through the ureter. This typically affects one side where the obstructing stone is located.
Irritable Bowel Syndrome
IBS leads to recurrent abdominal cramping and pelvic pain from abnormal gut spasms and motility. Pain typically occurs on the lower left side in IBS.
Urinary Tract Infection
Bacterial infections affecting the bladder or ureters cause pelvic pain and burning during urination. Pain may be worse on one side depending on the location of the infection.
Musculoskeletal Issues
Muscle strains or injuries involving structures like the sacroiliac joint or hip flexors can cause left pelvic and groin pain. Activities like exercise, heavy lifting and childbirth can lead to these issues.
Treatment Options
Treatment varies depending on the underlying cause of left pelvic pain. Some common treatment approaches may include:
- Pain medications – Over-the-counter drugs like ibuprofen can relieve discomfort from menstrual and muscular causes of pain. Prescription opioids may be used short-term for severe pain.
- Hormonal therapies – Birth control pills, progesterone and other hormonal treatments may be used to treat endometriosis and menstrual pain.
- Antibiotics – Bacterial infections require antibiotics tailored to the type of infection present.
- Surgical removal – Ovarian cysts, ectopic pregnancy and severely damaged tissues may need surgical removal for pain relief and to prevent complications.
- Dietary changes – Avoiding foods that aggravate IBS and diverticula can reduce associated pain.
- Warm compresses – Heat therapy can soothe muscle strains and menstrual cramps.
- Physical therapy – Stretches and exercises focused on core and pelvic muscles can help strengthen these areas and reduce pain.
The outlook is generally good with appropriate treatment. However, some conditions like endometriosis may require ongoing management to keep symptoms under control.
When to Seek Emergency Care
In some cases, left pelvic pain requires emergency medical care. Seek immediate help if you have:
- Severe sudden pain spreading from the pelvis to the shoulder or neck
- Fever over 101°F along with pelvic pain
- Fainting, dizziness or rapid heart rate
- Uncontrollable vaginal bleeding
- Inability to pass urine despite urgency
- Signs of shock like pale, cold, clammy skin; confusion; and rapid breathing
These symptoms can indicate a life-threatening problem requiring surgery like ovarian torsion, a ruptured ectopic pregnancy, kidney obstruction or pelvic abscess. Call 911 or go to the nearest emergency room right away if you have any of these issues.
Prevention
You may be able to reduce the risk of some causes of recurrent pelvic pain through:
- Practicing safe sex to avoid STDs that can lead to PID.
- Maintaining a healthy weight to lower risks for diverticula, cysts and hormonal imbalances.
- Eating more fiber to prevent constipation and diarrhea that aggravate IBS.
- Exercising regularly to strengthen core muscles supporting the pelvis.
- Avoiding smoking, which is associated with developing ovarian cysts.
- Managing stress through relaxation techniques, which can minimize IBS and menstrual pain.
However, some frequent causes like menstrual cramps and endometriosis may not always be preventable.
When to See Your Doctor for Left Pelvic Pain
Consult your doctor if you have any of the following:
- Persistent or worsening pelvic pain on one side
- Pelvic pain interfering with daily activities
- Pain during urination or intercourse
- Pelvic pain along with bleeding, discharge or fever
- Severe menstrual cramps lasting more than a few days
- Pelvic pain that alternates with abdominal or lower back pain
Your doctor can perform a full evaluation to determine the cause and create an effective treatment plan tailored to your symptoms and health history.
Conclusion
Left-sided pelvic pain has many potential causes ranging from menstrual issues to serious infections and structural problems. While brief, mild discomfort may resolve on its own, recurrent or severe pain should be evaluated promptly to identify any underlying condition requiring treatment. Seeing your doctor for a thorough diagnostic workup and appropriate care can help resolve discomfort and prevent complications.